Here in Seattle, my cousin Margaret is a teacher who has developed a program for children with serious developmental delay problems. This program called Options, involves placing these kids in their own class in a first rate school. Unlike the usual situation, the children are not isolated from society. The entire student body is involved in creating a community for these kids.

Margaret showed me her annual report - five pages long, filled with details of activities and field trips, including one to England. The program has had a major impact not only on the kids themselves, but also their families, the other children in the school, and the teachers. At the same time, it has lessened the children’s dependency on professionals such as therapists, neurologists, etc. She has received several national awards for her innovative work.

Margaret spoke with passion, her face radiated as she described what she had created. A few weeks ago, she quit her job. The administration had doubled the tuition on these kids, and in many ways undermined the work she had done.

Within a week of her resignation, because of her reputation, she was hired by an excellent school district. She will now be teaching normal children English. This is of little consolation to her. She remains filled with profound sadness for her kids and a sense of loss that this groundbreaking work will come to an end.

I shared with her my experiences working as a family physician for a corporation for four years. I too ultimately quit because of atrocious management and the way the practice was undermined. I too, spoke about the impact of my work extending beyond the patients to their families, friends, staff, and medical community. My practice was also a radical departure from the usual, since it involved elements of total quality improvement, traditional therapy, gestalt psychotherapy, and mind body medicine.

Margaret spoke about healing her students, I spoke about healing my patients. For her, teaching was more than instilling facts and skills. Medicine for me was more than curing the immediate illness. She described a case of a disabled child. I described a case of an eighty year old widow. We agreed that we did not place a value judgement on the life we were working with. We discovered a great overlap in what we each had been doing, and neither will be doing now. (If any one has access to Medical Economics, my story is being published in July.)

Some time ago, we were having dinner with a group of friends. In the background, I overheard Goldie telling someone: "You are doing really holy work." I turned to her and asked what work was she talking about. She replied that he designs guidance systems for missiles. I flipped.: "If that’s holy work, I wonder what isn’t!" was my retort.

It took a lot of processing till I figured out that it doesn’t necessarily take a "holy" person to do holy work. It has everything to do with intention. Our friend is working on missiles that will defend us from attack.

So while medicine remains focused on the battle over money, the rest of the world moves on. Last night I watched a TV show and saw an electrical engineer "cure" people by running his hands over their photographs. A non-physician from Canada was "curing" cancer by injecting some concoction at several hundred dollars a pop. He kept no records or statistics. Why not?

On the other hand there is much organized medicine can learn from complementary practitioners. In general we are resistant. Why? Perhaps its because it is much safer to fight the same old battles than to look at ourselves, see where we have taken the wrong turn in the road, heal ourselves and move forward. So the public is left unprotected, to fend for itself and sort out quackery from ethical care. Goldie talks about practicing "safe spirituality." I’m suggesting the concept of "safe healing."

I spoke to a highly regarded general surgeon here in Seattle. His income has plummeted as have those of most physicians here, and he is starting a computer company. Physician morale in this lovely, but expensive city is terrible. Nor will physicians tolerate any discussion about issues of personal morale, spirituality, complementary medicine, etc.

In yesterday’s New York Times, I read that the Justice Department has approved the acquisition of Prudential health insurance by Aetna. Already a major player in determining how healthcare is practiced, Aetna is about to become the leading managed care company. I have had dealings with Aetna over the years. There is a great deal I can write about but won’t.

In today’s news, the AMA approves a move to become a bargaining entity for physicians, basically a union. Instead of finding out where we went wrong, reformatting, becoming healers with our own code of ethics – not that of the managed care companies – we are engaging in a battle that will help our incomes and nothing else.

I refused to join the AMA. Considering their huge budget, I always thought that it did very little except act as a lobbying group for greedy physicians. It missed many opportunities to act proactively to deal with the issues of an overly expensive health care system. When pressured to join by the local state society, I resigned and created my own organization – The Physician Interactive Group.

I see neither organization as solving the healthcare problem. Essentially, the one is trying to maintain physicians’ incomes, the other cut them. Anyone who doubts this point of view, imagine walking into the boardroom of either and asking their philosophy of medicine as holy work.

Few doubt our obligation to fight for our constitution. I believe that just as sacred is our need to fight to retain spiritual integrity in those who teach our children, and help us when we are ill. Today, I could have spent the day working for some corporation. I could have seen thirty or forty patients. Instead I helped my daughter clean house and organize cabinets. Which did I prefer doing? No contest!